Provider Demographics
NPI:1962009175
Name:DESIGNER OPTICAL OF PLAINS PARKWAY INC
Entity type:Organization
Organization Name:DESIGNER OPTICAL OF PLAINS PARKWAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GUNIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:773-814-9216
Mailing Address - Street 1:2196A WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1406
Mailing Address - Country:US
Mailing Address - Phone:718-513-3577
Mailing Address - Fax:718-513-3579
Practice Address - Street 1:2196A WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1406
Practice Address - Country:US
Practice Address - Phone:718-513-3577
Practice Address - Fax:718-513-3579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty